Healthcare Provider Details

I. General information

NPI: 1699902114
Provider Name (Legal Business Name): JAMES GABEL KAFERLY III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 07/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 EAST ALBROOK DR. MONTBELLO FAMILY HEALTH CENTER OFFICE
DENVER CO
80239
US

IV. Provider business mailing address

660BANNOCK STREET DENVER HEALTH MEDICAL STAFF
DENVER CO
80204
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-4000
  • Fax:
Mailing address:
  • Phone: 303-602-2714
  • Fax: 303-602-2719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA121944
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0055351
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: